An Update on Paul

I'm going to interrupt my usual quirky observations with some straight-forward ones of Paul's progress over the weekend as he is too weak to blog himself at the moment.

He developed a temperature of 102 on Friday night (11.4.11) and we took him to the emergency room at Vanderbilt. That must be one of the busiest emergency rooms in America! Those people work very hard but it seemed to me they could use a few more people. And a few more rooms.

Because they were full (I've never seen an emergency room that full!) Paul waited in a secluded hall -he is still Neutropenic from his last round of Chemo two weeks ago. He has absolutely NO immune system. His white blood count is at 0.1 so he sat in a hall, away from people, until a bed opened up for him. About an hour. Once he was in a room they started him on antibiotics. His fever did seem to come down briefly that first night but overall, he maintained a temperature between 101-103 the entire weekend. His fever broke late Sunday afternoon.

Once in ER, we waited 15 hours for a regular hospital room to open up for him. During that time he slept as much as possible. He was feverish, chilled, nauseous, and had a headache. They were able to alleviate the nausea with meds but the rest stayed with him for a good while though they tried several things in an effort to make him more comfortable.

The Oncology floor where Leukemia patients usually go was full so he was given a room on another floor. One for Oncology overflow and general medicine. We got there Saturday afternoon and they continued with regular doses of antibiotics. His fever continued to be high.

During this time, lab results came back from some blood work done earlier in the week when they removed his PICC-line (it was looking VERY red around the site.) It was confirmed that he had a Staph infection. Probably a result of the PICC site. (Not unusual)

This allowed them to better target which antibiotics to use. During this time Paul remained very weak, nauseous, and feverish. His blood pressure was also low. He ate very little, if anything that day. Also somewhere in here they gave him some Platelets as they were too low.

In the middle of the night (Saturday/Sunday, around 3 AM,) Paul got up to use the bathroom. He must have gotten up too quickly. He fell as a result of momentarily blacking out. His IV pole also toppled with him, making a very loud noise. I awoke just in time to see him fall and I gave what was probably a good shout. Staff were immediately at the door. He regained consciousness almost immediately but was very dazed. As he was right in front of the door, I was unable to open the door to the large number of hospital staff on the other side until I helped Paul up. We (Paul and I) did manage to get him up and the staff in fairly quickly, I think. It's all a bit surreal now.

Also, now that we know everything is ok, I'll tell you about this part. As I helped him up I saw a pool of blood where his head had been. I refused to react to that at that moment, and kept getting him up so we could get the staff in the door. The blood turned out to be from a cracked IV line, but for the moment it greatly augmented the alarming state of things for me as you can imagine.

He did hit his head during that fall but showed no signs of injury. They did a CAT scan just to be sure. They also put him in "bed jail." The beds are wired with an alarm that, when activated, will sound every time the person gets out of bed. This requires an attendant to be there at all times when the patient is getting up. He stayed on "bed jail" - my term, obviously - for about 24 hours. They also switched his "booties" - non-slip socks they give-from blue to yellow. Apparently yellow have thicker and larger amounts of non-skid material on them. As many of us already think of him as Tom Bombadil (who had yellow boots), I particularly enjoy this added feature. Gives me something to smile about. He's so cute!

OK. In all fairness I should show you the first picture I took of him. It actually encapsulates his overall essence these past few days better. His radiant smile has only just broken through this morning. The picture with him smiling came after I said, well, I don't know what I said but it caused him to smile real big.

Sunday afternoon his fever finally broke and has remained normal since. That was a very welcomed milestone.

Sunday evening, I'm sorry to say, brought another eventful night. Earlier in the day he received an order for blood transfusions and some platelets. Transfusions are a very normal thing for people who have Chemo. Transfusions sustain them until their body recovers and produces its own blood cells.

His blood transfusions began about 5:30 p.m. About half way through his second bag of blood (around 9 PM) Paul experienced what he described as a heavy weight on his chest. He was also nauseated and his forehead broke out in a sweat. There was also an immediate need for the restroom facility with a sudden onslaught of diarrhea. The staff paused the blood transfusion in case he was having a reaction and sent for a cardiologist. There was an EKG taken as well as blood drawn for labs.

EKG was normal. After a good amount of examination, nothing seemed out of the ordinary and Paul settled in for bed.

Around 3 AM a resident doctor came up to talk to us. There were heart stress enzymes in his blood. This is indicative of a heart attack. Even mild. There were several tests run the rest of the night.

This morning the heads of Cardiology came to see Paul. They furthered the questioning and examinations. The head of the department said that, given the events, blood work, and description of last night, he would have to conclude Paul did experience a mild heart attack. He did not think this was related to the blood transfusion. He suggested the timing was a coincidence. They are proceeding with what testing they can today.

As Paul's platelets are low, they cannot do exploratory anything that requires threading tubing inside Paul's arteries. Our course of action is to continue to give blood and platelet transfusions and closely monitor Paul externally.

There are many factors to consider. His low blood pressure. Low blood volume. His last Chemo has a side effect of damaging the heart. But Paul seems completely fine. He wouldn't even describe the experience as painful in any way. If the nurse administering the blood transfusion hadn't told him to report anything that wasn't normal, he wouldn't have even mentioned it(!) as it wasn't painful.

So that brings us to this morning. "Joy comes in the morning!"

When Paul awoke this morning (after not much sleep) he was NOTICEABLY more his usual self!!! More alert. Smiles even. Willing to try his breakfast. He clearly felt better. He asked if he could walk a bit so we walked the floor loop a few times. He's back to checking and answering texts and emails a little bit. He's still weak but he's just so much better today. His temperature continues to be normal. I am relieved. (And happy for him!)

Thank you so much to all who have continually prayed for him. As you can see, his body is really working hard for him! And not without consequence.

We love you all. Thank you for being on this trek with us. I'll leave you with Paul's view this morning and his wonderful comment, "Those hills are beautiful!" I think a lot of people would have seen the cement buildings and limited view. Paul looks past all that and finds the beauty. Never have I met such a man who immediately finds God's beauty, presence, desire for each moment!! Even after the heart stuff yesterday his comment was, "I'm so glad God let this happen today instead of yesterday!"

PS - Just so you know, he'll probably cry when he reads this update. He's VERY tender right now. Tears up whenever I bring something sweet, pleasant, loving to his notice. Sunday morning I casually mentioned, "Everybody's probably gathering today. That means a lot of prayer will go up for you." And I smiled. And he teared up. Did I mention how much I love this amazing man? As I tear up...